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International Journal of Colorectal Disease

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01-10-2010 | Original Article

Doppler-guided haemorrhoidal artery ligation with recto anal repair: a new technique for the treatment of symptomatic haemorrhoids

Authors: Neil P. Forrest, Jose Mullerat, Charles Evans, Simon B. Middleton

Published in: International Journal of Colorectal Disease | Issue 10/2010

Abstract

Purpose

Doppler-guided haemorrhoidal artery ligation (DGHAL) is a minimally invasive surgical technique used to treat symptomatic haemorrhoids. In 2005, the DGHAL proctoscope was redesigned to incorporate a window through which a recto anal repair (RAR) could be performed to improve the outcome in patients with significant prolapse symptoms. The aim of this study was to observe the outcome of a series of consecutive DGHAL–RAR procedures.

Method

Seventy-seven consecutive patients (49 male) underwent DGHAL–RAR for symptomatic haemorrhoids and were reviewed for a minimum of 6 months post-surgery.

Results

Fifty-seven (74%) of patients presented with both prolapse and bleeding symptoms. The median number of DGHALs performed was six, and the median number of RARs was two. Most (96%) patients were discharged the same day. At follow-up, 11 patients complained of recurrent symptoms, five of prolapse, four of bleeding and two of pruritus. Eight patients suffered with post-operative anal fissures. The procedure is recommended by 84.4% of patients 6 weeks post-surgery.

Conclusion

DGHAL–RAR is safe, effective and well tolerated. It reduces the need for potentially dangerous excisional procedures. The RAR component is an effective addition to DGHAL in the short term for the treatment of prolapse, but longer follow-up will be required to demonstrate durability of the technique.

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Title: Doppler-guided haemorrhoidal artery ligation with recto anal repair: a new technique for the treatment of symptomatic haemorrhoids
Authors: Neil P. Forrest
Jose Mullerat
Charles Evans
Simon B. Middleton
Publication date: 01-10-2010
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 10/2010
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-010-0951-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Doppler-guided haemorrhoidal artery ligation with recto anal repair: a new technique for the treatment of symptomatic haemorrhoids

Abstract

Purpose

Method

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Method

Results

Conclusion

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